14,273 research outputs found
Digital support interventions for the self-management of low back pain: a systematic review
Background: Low back pain (LBP) is a common cause of disability and is ranked as the most burdensome health condition globally. Self-management, including components on increased knowledge, monitoring of symptoms, and physical activity, are consistently recommended in clinical guidelines as cost-effective strategies for LBP management and there is increasing interest in the potential role of digital health.
Objective: The study aimed to synthesize and critically appraise published evidence concerning the use of interactive digital interventions to support self-management of LBP. The following specific questions were examined: (1) What are the key components of digital self-management interventions for LBP, including theoretical underpinnings? (2) What outcome measures have been used in randomized trials of digital self-management interventions in LBP and what effect, if any, did the intervention have on these? and (3) What specific characteristics or components, if any, of interventions appear to be associated with beneficial outcomes?
Methods: Bibliographic databases searched from 2000 to March 2016 included Medline, Embase, CINAHL, PsycINFO, Cochrane Library, DoPHER and TRoPHI, Social Science Citation Index, and Science Citation Index. Reference and citation searching was also undertaken. Search strategy combined the following concepts: (1) back pain, (2) digital intervention, and (3) self-management. Only randomized controlled trial (RCT) protocols or completed RCTs involving adults with LBP published in peer-reviewed journals were included. Two reviewers independently screened titles and abstracts, full-text articles, extracted data, and assessed risk of bias using Cochrane risk of bias tool. An independent third reviewer adjudicated on disagreements. Data were synthesized narratively.
Results: Of the total 7014 references identified, 11 were included, describing 9 studies: 6 completed RCTs and 3 protocols for future RCTs. The completed RCTs included a total of 2706 participants (range of 114-1343 participants per study) and varied considerably in the nature and delivery of the interventions, the duration/definition of LBP, the outcomes measured, and the effectiveness of the interventions. Participants were generally white, middle aged, and in 5 of 6 RCT reports, the majority were female and most reported educational level as time at college or higher. Only one study reported between-group differences in favor of the digital intervention. There was considerable variation in the extent of reporting the characteristics, components, and theories underpinning each intervention. None of the studies showed evidence of harm.
Conclusions: The literature is extremely heterogeneous, making it difficult to understand what might work best, for whom, and in what circumstances. Participants were predominantly female, white, well educated, and middle aged, and thus the wider applicability of digital self-management interventions remains uncertain. No information on cost-effectiveness was reported. The evidence base for interactive digital interventions to support patient self-management of LBP remains weak
Alter ego, state of the art on user profiling: an overview of the most relevant organisational and behavioural aspects regarding User Profiling.
This report gives an overview of the most relevant organisational and\ud
behavioural aspects regarding user profiling. It discusses not only the\ud
most important aims of user profiling from both an organisation’s as\ud
well as a user’s perspective, it will also discuss organisational motives\ud
and barriers for user profiling and the most important conditions for\ud
the success of user profiling. Finally recommendations are made and\ud
suggestions for further research are given
Perspectives of healthcare providers on the nutritional management of patients on haemodialysis in Australia: An interview study
Objective To describe the perspectives of healthcare providers on the nutritional management of patients on haemodialysis, which may inform strategies for improving patient-centred nutritional care. Design Face-to-face semistructured interviews were conducted until data saturation, and thematic analysis based on principles of grounded theory. Setting 21 haemodialysis centres across Australia. Participants 42 haemodialysis clinicians (nephrologists and nephrology trainees (15), nurses (12) and dietitians (15)) were purposively sampled to obtain a range of demographic characteristics and clinical experiences. Results Six themes were identified: responding to changing clinical status (individualising strategies to patient needs, prioritising acute events, adapting guidelines), integrating patient circumstances (assimilating life priorities, access and affordability), delineating specialty roles in collaborative structures (shared and cohesive care, pivotal role of dietary expertise, facilitating access to nutritional care, perpetuating conflicting advice and patient confusion, devaluing nutritional specialty), empowerment for behaviour change (enabling comprehension of complexities, building autonomy and ownership, developing self-efficacy through engagement, tailoring self-management strategies), initiating and sustaining motivation (encountering motivational hurdles, empathy for confronting life changes, fostering non-judgemental relationships, emphasising symptomatic and tangible benefits, harnessing support networks), and organisational and staffing barriers (staffing shortfalls, readdressing system inefficiencies). Conclusions Organisational support with collaborative multidisciplinary teams and individualised patient care were seen as necessary for developing positive patient-clinician relationships, delivering consistent nutrition advice, and building and sustaining patient motivation to enable change in dietary behaviour. Improving service delivery and developing and delivering targeted, multifaceted self-management interventions may enhance current nutritional management of patients on haemodialysis
Opening the Black Box: Explaining the Process of Basing a Health Recommender System on the I-Change Behavioral Change Model
Recommender systems are gaining traction in healthcare because they can tailor recommendations
based on users' feedback concerning their appreciation of previous health-related messages. However,
recommender systems are often not grounded in behavioral change theories, which may further increase
the effectiveness of their recommendations. This paper's objective is to describe principles for designing
and developing a health recommender system grounded in the I-Change behavioral change model that
shall be implemented through a mobile app for a smoking cessation support clinical trial. We built upon
an existing smoking cessation health recommender system that delivered motivational messages through a
mobile app. A group of experts assessed how the system may be improved to address the behavioral change
determinants of the I-Change behavioral change model. The resulting system features a hybrid recommender
algorithm for computer tailoring smoking cessation messages. A total of 331 different motivational messages
were designed using 10 health communication methods. The algorithm was designed to match 58 message
characteristics to each user pro le by following the principles of the I-Change model and maintaining the
bene ts of the recommender system algorithms. The mobile app resulted in a streamlined version that aimed
to improve the user experience, and this system's design bridges the gap between health recommender
systems and the use of behavioral change theories. This article presents a novel approach integrating
recommender system technology, health behavior technology, and computer-tailored technology. Future
researchers will be able to build upon the principles applied in this case study.European Union's Horizon 2020 Research and Innovation Programme under Grant 68112
Analyzing recommender systems for health promotion using a multidisciplinary taxonomy: A scoping review
Background: Recommender systems are information retrieval systems that provide users with relevant items
(e.g., through messages). Despite their extensive use in the e-commerce and leisure domains, their application in
healthcare is still in its infancy. These systems may be used to create tailored health interventions, thus reducing
the cost of healthcare and fostering a healthier lifestyle in the population.
Objective: This paper identifies, categorizes, and analyzes the existing knowledge in terms of the literature
published over the past 10 years on the use of health recommender systems for patient interventions. The aim of
this study is to understand the scientific evidence generated about health recommender systems, to identify any
gaps in this field to achieve the United Nations Sustainable Development Goal 3 (SDG3) (namely, “Ensure healthy
lives and promote well-being for all at all ages”), and to suggest possible reasons for these gaps as well as to
propose some solutions.
Methods: We conducted a scoping review, which consisted of a keyword search of the literature related to health
recommender systems for patients in the following databases: ScienceDirect, PsycInfo, Association for Computing
Machinery, IEEExplore, and Pubmed. Further, we limited our search to consider only English-lan-guage journal
articles published in the last 10 years. The reviewing process comprised three researchers who filtered the results
simultaneously. The quantitative synthesis was conducted in parallel by two researchers, who classified each
paper in terms of four aspects—the domain, the methodological and procedural aspects, the health promotion
theoretical factors and behavior change theories, and the technical aspects—using a new multidisciplinary
taxonomy.
Results: Nineteen papers met the inclusion criteria and were included in the data analysis, for which thirty-three
features were assessed. The nine features associated with the health promotion theoretical factors and behavior
change theories were not observed in any of the selected studies, did not use principles of tailoring, and did not
assess (cost)-effectiveness.
Discussion: Health recommender systems may be further improved by using relevant behavior change strategies
and by implementing essential characteristics of tailored interventions. In addition, many of the features required
to assess each of the domain aspects, the methodological and procedural aspects, and technical aspects
were not reported in the studies.
Conclusions: The studies analyzed presented few evidence in support of the positive effects of using health recommender
systems in terms of cost-effectiveness and patient health outcomes. This is why future studies should
ensure that all the proposed features are covered in our multidisciplinary taxonomy, including integration with
electronic health records and the incorporation of health promotion theoretical factors and behavior change
theories. This will render those studies more useful for policymakers since they will cover all aspects needed to
determine their impact toward meeting SDG3.European Union's Horizon 2020 No 68112
Tailoring persuasive health games to gamer type
Persuasive games are an effective approach for motivating health behavior, and recent years have seen an increase in games designed for changing human behaviors or attitudes. However, these games are limited in two major ways: first, they are not based on theories of what motivates healthy behavior change. This makes it difficult to evaluate why a persuasive approach works. Second, most persuasive games treat players as a monolithic group. As an attempt to resolve these weaknesses, we conducted a large-scale survey of 642 gamers' eating habits and their associated determinants of healthy behavior to understand how health behavior relates to gamer type. We developed seven different models of healthy eating behavior for the gamer types identified by BrainHex. We then explored the differences between the models and created two approaches for effective persuasive game design based on our results. The first is a one-size-fits-all approach that will motivate the majority of the population, while not demotivating any players. The second is a personalized approach that will best motivate a particular type of gamer. Finally, to make our approaches actionable in persuasive game design, we map common game mechanics to the determinants of healthy behavior
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Behaviors That Eliminate Health Disparities for Racial and Ethnic Minorities: A Narrative Systematic Review
Within the health care provider-health care recipient relationship the communication must be culturally competent to eliminate barriers to equitable health care for all Americans. This assertion has conceptual grounding in Public Law 106-129 (the Health Care Research and Quality Act of 1999) and Public Law 106-525 (the Minority Health and Health Disparities Research and Education Act of 2000). This narrative systematic review examines this assertion by using selection and exclusion criteria to gather interventions, assessments, and testimonies conducted from 2000-2007. Reports that were not eliminated via these criteria were analyzed to determine the effect of specific practices that were undertaken in interventions, assessments, and testimonies. Which practices does research propose as indispensable to efforts to eliminate health disparities for racial and ethnic minority health care recipients? Findings indicate that culturally competent behaviors by providers and recipients promote effective intercultural communication that eliminates health care disparities, and removes obstacles to care
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